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General NPI Number Information
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NPI Number | 1861487746
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Entity Type | Individual
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Provider Name | JACQUELINE PERCY
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Gender | Female
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 06/08/2018
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Provider Practice Location Address
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Address Line | BITBURG HOSPITAL
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City | BITBURG AIR BASE
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State | BITBURG
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Zip | 95634
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Country | DE
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Telephone | 011496561693456
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 118 BOX 714
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City | APO
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State | AE
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Zip | 09137
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Country | DE
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Telephone | 011496561695172
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DR.0055855
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0055855
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01057679A
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License Number State | IN
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